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E u r o S c i C o n C o n f e r e n c e o n
PEDIATRICS
2017
Pediatrics 2017
Volume:3 Issue:4(Suppl)
Journal of Pediatric Care
ISSN 2471-805X
N o v e m b e r 1 3 - 1 4 , 2 0 1 7
L o n d o n , U K
Page 37
Background:
There is limited knowledge regarding long term
follow-up of milk allergic patients who tolerate baked milk
(BM) products.
Objective:
The objective of the study is to evaluate the long-
term safety and efficacy of this intervention.
Patients & Methods:
Children with IgE-mediated milk allergy
underwent an oral challenge with BM. Those who tolerated
BM underwent baked cheese pizza (BC) challenge after 6
months. Six months later, a challenge with unheated milk was
offered to patients who tolerated BC.
Results:
85 children (median 5.2 years; range 15 months to 15
Long term outcomes
following baked
milk-containing diet
for IgE-mediated milk
allergy
Ilan Dalal
1,4
, Jenny Weinbrand
Goichberg
1
, Shira Benor
2
,
Menahem Rottem
3
, Nitzan
Shacham
1
, Avigdor Man-
delberg
4
, Arie Levine
4
, Koby
Sade
2
and Shmuel Kivity
2
1
Wolfson Medical Center, Israel
2
Tel Aviv Sourasky Medical Center
3
Haemek Medical Center, Israel
4
Sackler faculty of medicine - Tel Aviv Universi-
ty, Israel
J Pediatr Care 2017, 3:4(Suppl)
DOI: 10.21767/2471-805X-C1-003
years) were prospectively followed for a median of 29 months
(range 15-50 months). Fifteen (18%) reacted to the initial BM
challenge. Reactions were mild in most cases and only 3 had
anaphylaxis. Among 70 (82%) children who initially tolerated
BM challenge, 26 (37%) tolerated unheated milk at last follow
up, 16 (23%) tolerated BM/BC and 25 (36%) avoided all forms
of milk despite successful initial BM/BC challenges. Another
3 patients (4%) were lost to follow-up. Predictive parameters
of reactivity to initial BM challenge include age (median - 7;
range 2.5-15 years vs. 3.5; range 1-14.5 years; P= 0.02), mild
respiratory symptoms (67% vs. 26%, P<0.01) as part of the
reported allergic reaction to milk, asthma (53% vs. 14.3%, P<
0.01) and a larger SPT to casein (median 14; range 8-28 mm vs.
6; range 0-18 mm; P<0.01)
Conclusions:
For most of our patients, ingestion of BM was
found to be safe and well tolerated. However, initial successful
challenge with BM/BC does not always guarantee ongoing
consumption of these products. Better predictors of response
are needed for patient selection and long-term outcomes.
ilandalal@hotmail.com Dalal@wmc.gov.il